Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis

Yi Mu; Ashkan Dashtban; Mehrdad A Mizani; Chris Tomlinson; Mohamed Mohamed; Mark Ashworth; Mamas Mamas; Rouven Priedon; Steffen Petersen; Evan Kontopantelis; Kim Horstmanshof; Christina Pagel; Mevhibe Hocaoğlu; Kamlesh Khunti; Richard Williams; Johan Thygesen; Paula Lorgelly; Manuel Gomes; Melissa Heightman; Amitava Banerjee; CVD-COVID-UK/COVID-IMPACT  Consortium

doi:10.1177/01410768241288345

Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis

Yi Mu, Ashkan Dashtban, Mehrdad A Mizani, Chris Tomlinson, Mohamed Mohamed, Mark Ashworth, Mamas Mamas, Rouven Priedon, Steffen Petersen, Evan Kontopantelis, Kim Horstmanshof, Christina Pagel, Mevhibe Hocaoğlu, Kamlesh Khunti, Richard Williams, Johan Thygesen, Paula Lorgelly, Manuel Gomes, Melissa Heightman, Amitava Banerjee CVD-COVID-UK/COVID-IMPACT Consortium (Collaborator)

Research output: Contribution to journal › Article › peer-review

Abstract

OBJECTIVES: To investigate healthcare utilisation and cost in individuals with long COVID (LC) at population level.

DESIGN: Case-control cohort analysis with multiple age-, sex-, ethnicity-, deprivation-, region- and comorbidity-matched control groups: (1) COVID only, no LC; (2) pre-pandemic; (3) contemporary non-COVID; and (4) pre-LC (self-controlled, pre-COVID pandemic).

SETTING: National, population-based, linked UK electronic health records (British Heart Foundation/NHS England Secure Data Environment).

PARTICIPANTS: Adults aged ≥18 years with LC between January 2020 and January 2023.

MAIN OUTCOME MEASURES: Healthcare utilisation (number of consultations/visits per person: primary care (general practitioner [GP]), secondary care (outpatient [OP], inpatient [IP] and emergency department [ED], investigations and procedures) and inflation-adjusted cost (£) for LC and control populations per month, calendar year and pandemic year for each category.

RESULTS: A total of 282,080 individuals with LC were included between January 2020 and January 2023. The control groups were COVID only, no LC ( n = 1,112,370), pre-pandemic ( n = 1,031,285), contemporary non-COVID ( n = 1,118,360) and pre-LC ( n = 282,080). Healthcare utilisation per person (per month/year) was higher in LC than controls across GP, OP and ED. For IP, LC had higher healthcare utilisation than pre-LC and contemporary non-COVID (all p < 0.0001). Healthcare utilisation of the LC group increased progressively between 2020 and 2023, compared with controls. Median cost per patient/year was also higher in individuals with LC than all control groups.

CONCLUSIONS: LC has been associated with substantial, persistent healthcare utilisation and cost over the last three years. Future funding, resources and staff for LC prevention, treatment and research must be prioritised to reduce sustained primary and secondary healthcare utilisation and costs.

Original language	English
Pages (from-to)	369-381
Number of pages	13
Journal	Journal of the Royal Society of Medicine
Volume	117
Issue number	11
DOIs	https://doi.org/10.1177/01410768241288345
Publication status	Published - Nov 2024

Keywords

Humans
COVID-19/epidemiology
Male
Female
Middle Aged
Aged
Case-Control Studies
Patient Acceptance of Health Care/statistics & numerical data
Adult
Longitudinal Studies
SARS-CoV-2
United Kingdom/epidemiology
Post-Acute COVID-19 Syndrome
Primary Health Care/statistics & numerical data
Aged, 80 and over
Health Care Costs/statistics & numerical data
Pandemics
Hospitalization/statistics & numerical data
Cohort Studies

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1177/01410768241288345

Cite this

Mu, Y., Dashtban, A., Mizani, M. A., Tomlinson, C., Mohamed, M., Ashworth, M., Mamas, M., Priedon, R., Petersen, S., Kontopantelis, E., Horstmanshof, K., Pagel, C., Hocaoğlu, M., Khunti, K., Williams, R., Thygesen, J., Lorgelly, P., Gomes, M., Heightman, M., ... Consortium, CVD.-COVID.-UKCOVID.-IMPACT. (2024). Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis. Journal of the Royal Society of Medicine, 117(11), 369-381. https://doi.org/10.1177/01410768241288345

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title = "Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis",

abstract = "OBJECTIVES: To investigate healthcare utilisation and cost in individuals with long COVID (LC) at population level.DESIGN: Case-control cohort analysis with multiple age-, sex-, ethnicity-, deprivation-, region- and comorbidity-matched control groups: (1) COVID only, no LC; (2) pre-pandemic; (3) contemporary non-COVID; and (4) pre-LC (self-controlled, pre-COVID pandemic).SETTING: National, population-based, linked UK electronic health records (British Heart Foundation/NHS England Secure Data Environment).PARTICIPANTS: Adults aged ≥18 years with LC between January 2020 and January 2023.MAIN OUTCOME MEASURES: Healthcare utilisation (number of consultations/visits per person: primary care (general practitioner [GP]), secondary care (outpatient [OP], inpatient [IP] and emergency department [ED], investigations and procedures) and inflation-adjusted cost (£) for LC and control populations per month, calendar year and pandemic year for each category.RESULTS: A total of 282,080 individuals with LC were included between January 2020 and January 2023. The control groups were COVID only, no LC ( n = 1,112,370), pre-pandemic ( n = 1,031,285), contemporary non-COVID ( n = 1,118,360) and pre-LC ( n = 282,080). Healthcare utilisation per person (per month/year) was higher in LC than controls across GP, OP and ED. For IP, LC had higher healthcare utilisation than pre-LC and contemporary non-COVID (all p < 0.0001). Healthcare utilisation of the LC group increased progressively between 2020 and 2023, compared with controls. Median cost per patient/year was also higher in individuals with LC than all control groups. CONCLUSIONS: LC has been associated with substantial, persistent healthcare utilisation and cost over the last three years. Future funding, resources and staff for LC prevention, treatment and research must be prioritised to reduce sustained primary and secondary healthcare utilisation and costs.",

keywords = "Humans, COVID-19/epidemiology, Male, Female, Middle Aged, Aged, Case-Control Studies, Patient Acceptance of Health Care/statistics & numerical data, Adult, Longitudinal Studies, SARS-CoV-2, United Kingdom/epidemiology, Post-Acute COVID-19 Syndrome, Primary Health Care/statistics & numerical data, Aged, 80 and over, Health Care Costs/statistics & numerical data, Pandemics, Hospitalization/statistics & numerical data, Cohort Studies",

author = "Yi Mu and Ashkan Dashtban and Mizani, {Mehrdad A} and Chris Tomlinson and Mohamed Mohamed and Mark Ashworth and Mamas Mamas and Rouven Priedon and Steffen Petersen and Evan Kontopantelis and Kim Horstmanshof and Christina Pagel and Mevhibe Hocaoğlu and Kamlesh Khunti and Richard Williams and Johan Thygesen and Paula Lorgelly and Manuel Gomes and Melissa Heightman and Amitava Banerjee and CVD-COVID-UK/COVID-IMPACT Consortium",

year = "2024",

month = nov,

doi = "10.1177/01410768241288345",

language = "English",

volume = "117",

pages = "369--381",

journal = "Journal of the Royal Society of Medicine",

issn = "0141-0768",

publisher = "Sage Publications Ltd",

number = "11",

}

Mu, Y, Dashtban, A, Mizani, MA, Tomlinson, C, Mohamed, M, Ashworth, M, Mamas, M, Priedon, R, Petersen, S, Kontopantelis, E, Horstmanshof, K, Pagel, C, Hocaoğlu, M, Khunti, K, Williams, R, Thygesen, J, Lorgelly, P, Gomes, M, Heightman, M, Banerjee, A & Consortium, CVD-COVID-UKCOVID-IMPACT 2024, 'Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis', Journal of the Royal Society of Medicine, vol. 117, no. 11, pp. 369-381. https://doi.org/10.1177/01410768241288345

TY - JOUR

T1 - Healthcare utilisation of 282,080 individuals with long COVID over two years

T2 - a multiple matched control, longitudinal cohort analysis

AU - Mu, Yi

AU - Dashtban, Ashkan

AU - Mizani, Mehrdad A

AU - Tomlinson, Chris

AU - Mohamed, Mohamed

AU - Ashworth, Mark

AU - Mamas, Mamas

AU - Priedon, Rouven

AU - Petersen, Steffen

AU - Kontopantelis, Evan

AU - Horstmanshof, Kim

AU - Pagel, Christina

AU - Hocaoğlu, Mevhibe

AU - Khunti, Kamlesh

AU - Williams, Richard

AU - Thygesen, Johan

AU - Lorgelly, Paula

AU - Gomes, Manuel

AU - Heightman, Melissa

AU - Banerjee, Amitava

A2 - Consortium, CVD-COVID-UK/COVID-IMPACT

PY - 2024/11

Y1 - 2024/11

N2 - OBJECTIVES: To investigate healthcare utilisation and cost in individuals with long COVID (LC) at population level.DESIGN: Case-control cohort analysis with multiple age-, sex-, ethnicity-, deprivation-, region- and comorbidity-matched control groups: (1) COVID only, no LC; (2) pre-pandemic; (3) contemporary non-COVID; and (4) pre-LC (self-controlled, pre-COVID pandemic).SETTING: National, population-based, linked UK electronic health records (British Heart Foundation/NHS England Secure Data Environment).PARTICIPANTS: Adults aged ≥18 years with LC between January 2020 and January 2023.MAIN OUTCOME MEASURES: Healthcare utilisation (number of consultations/visits per person: primary care (general practitioner [GP]), secondary care (outpatient [OP], inpatient [IP] and emergency department [ED], investigations and procedures) and inflation-adjusted cost (£) for LC and control populations per month, calendar year and pandemic year for each category.RESULTS: A total of 282,080 individuals with LC were included between January 2020 and January 2023. The control groups were COVID only, no LC ( n = 1,112,370), pre-pandemic ( n = 1,031,285), contemporary non-COVID ( n = 1,118,360) and pre-LC ( n = 282,080). Healthcare utilisation per person (per month/year) was higher in LC than controls across GP, OP and ED. For IP, LC had higher healthcare utilisation than pre-LC and contemporary non-COVID (all p < 0.0001). Healthcare utilisation of the LC group increased progressively between 2020 and 2023, compared with controls. Median cost per patient/year was also higher in individuals with LC than all control groups. CONCLUSIONS: LC has been associated with substantial, persistent healthcare utilisation and cost over the last three years. Future funding, resources and staff for LC prevention, treatment and research must be prioritised to reduce sustained primary and secondary healthcare utilisation and costs.

AB - OBJECTIVES: To investigate healthcare utilisation and cost in individuals with long COVID (LC) at population level.DESIGN: Case-control cohort analysis with multiple age-, sex-, ethnicity-, deprivation-, region- and comorbidity-matched control groups: (1) COVID only, no LC; (2) pre-pandemic; (3) contemporary non-COVID; and (4) pre-LC (self-controlled, pre-COVID pandemic).SETTING: National, population-based, linked UK electronic health records (British Heart Foundation/NHS England Secure Data Environment).PARTICIPANTS: Adults aged ≥18 years with LC between January 2020 and January 2023.MAIN OUTCOME MEASURES: Healthcare utilisation (number of consultations/visits per person: primary care (general practitioner [GP]), secondary care (outpatient [OP], inpatient [IP] and emergency department [ED], investigations and procedures) and inflation-adjusted cost (£) for LC and control populations per month, calendar year and pandemic year for each category.RESULTS: A total of 282,080 individuals with LC were included between January 2020 and January 2023. The control groups were COVID only, no LC ( n = 1,112,370), pre-pandemic ( n = 1,031,285), contemporary non-COVID ( n = 1,118,360) and pre-LC ( n = 282,080). Healthcare utilisation per person (per month/year) was higher in LC than controls across GP, OP and ED. For IP, LC had higher healthcare utilisation than pre-LC and contemporary non-COVID (all p < 0.0001). Healthcare utilisation of the LC group increased progressively between 2020 and 2023, compared with controls. Median cost per patient/year was also higher in individuals with LC than all control groups. CONCLUSIONS: LC has been associated with substantial, persistent healthcare utilisation and cost over the last three years. Future funding, resources and staff for LC prevention, treatment and research must be prioritised to reduce sustained primary and secondary healthcare utilisation and costs.

KW - Humans

KW - COVID-19/epidemiology

KW - Male

KW - Female

KW - Middle Aged

KW - Aged

KW - Case-Control Studies

KW - Patient Acceptance of Health Care/statistics & numerical data

KW - Adult

KW - Longitudinal Studies

KW - SARS-CoV-2

KW - United Kingdom/epidemiology

KW - Post-Acute COVID-19 Syndrome

KW - Primary Health Care/statistics & numerical data

KW - Aged, 80 and over

KW - Health Care Costs/statistics & numerical data

KW - Pandemics

KW - Hospitalization/statistics & numerical data

KW - Cohort Studies

U2 - 10.1177/01410768241288345

DO - 10.1177/01410768241288345

M3 - Article

C2 - 39603265

SN - 0141-0768

VL - 117

SP - 369

EP - 381

JO - Journal of the Royal Society of Medicine

JF - Journal of the Royal Society of Medicine

IS - 11

ER -

Healthcare utilisation of 282,080 individuals with long COVID over two years: a multiple matched control, longitudinal cohort analysis

Abstract

Keywords

UN SDGs

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